ISTH interim guidance on recognition and management of coagulopathy in COVID‐19

Thachil, Jecko; Tang, Ning; Gando, Satoshi; Falanga, Anna; Cattaneo, Marco; Levi, Marcel; Clark, Cary; Iba, Toshiaki

doi:10.1111/jth.14810

Cited by 1,750 publications

(2,021 citation statements)

References 16 publications

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“…13,14,19 Continued investigation of these pathological processes and the utility of their biomarkers is needed given recent reports of corticosteroid use and ongoing clinical trials of IL-6-receptor antagonists among COVID-19 inpatients, as well as rapidly evolving guidelines for anti-coagulation in this population. 17,20,21 Consistent with unadjusted data from China, 3 and Italy, 8 hypertension was independently associated with poor in-hospital survival. Given the globally high burden of hypertension and emerging understanding of interactions between SARS-CoV-2 and angiotensin-convertingenzyme-2, 22 further investigations are needed to better define a relationship, if any, between hypertension, exposure to renin angiotensin aldosterone system antagonists, and severe COVID-19.…”

Section: Discussionmentioning

confidence: 64%

Temporal detection and phylogenetic assessment of SARS-CoV-2 in municipal wastewater

Nemudryi

Nemudraia

Wiegand

et al. 2020

Preprint

157

205

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SARS-CoV-2 has recently been detected in feces, which indicates that wastewater may be used to monitor viral prevalence in the community. Here we use RT-qPCR to monitor wastewater for SARS-CoV-2 RNA over a 52-day time course. We show that changes in SARS-CoV-2 RNA concentrations correlate with local COVID-19 epidemiological data (R2=0.9), though detection in wastewater trails symptom onset dates by 5-8 days. We determine a near-complete (98.5%) SARS-CoV-2 genome sequence from the wastewater and use phylogenic analysis to infer viral ancestry. Collectively, this work demonstrates how wastewater can be used as a proxy to monitor viral prevalence in the community and how genome sequencing can be used for high-resolution genotyping of the predominant strains circulating in a community.

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Section: Discussionmentioning

confidence: 64%

Temporal detection and phylogenetic assessment of SARS-CoV-2 in municipal wastewater

Nemudryi

Nemudraia

Wiegand

et al. 2020

Preprint

157

205

View full text Add to dashboard Cite

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“…Así, se ha descrito en estos pacientes una elevación del dímero D, que se asocia con un peor pronóstico e incluso predice la mortalidad 4,5 . Por lo tanto, se debe tener en cuenta una elevación de 2-3 veces el valor normal, incluso en presencia de síntomas leves 6,7 . Junto a ello, se ha detectado un discreto alargamiento del tiempo de protrombina en los pacientes con síntomas graves.…”

Section: Mecanismos Que Participan En El Estado Protrombótico De La Iunclassified

“…La ISTH propone la determinación y la monitorización de 4 parámetros: dímero D, tiempo de protrombina, cifra de plaquetas y fibrinógeno, para estratificar a los pacientes e identificar a aquellos con mal pronóstico, con objeto de someterlos a una monitorización más intensiva e incluso modificar su tratamiento. Es interesante que se considere que las hemorragias no son infrecuentes en estos pacientes, y en caso de que se produzcan, el tratamiento debe ser sustitutivo y mantener cifras de plaquetas > 50 × 10 9 /l, el fibrinógeno > 2 g/l y un cociente del tiempo de protrombina > 1,5 7 .…”

Section: Mecanismos Que Participan En El Estado Protrombótico De La Iunclassified

“…Los estudios de Thachil et al 7 proponen que se debe considerar dosis profilácticas de HBPM para todos los pacientes que precisen ingreso hospitalario, en ausencia de contraindicaciones (como hemorragia activa o recuento plaquetario < 25 × 10 9 /l), con ajuste de dosis para los pacientes con elevación franca de dímero D y aquellos que presentan criterios de gravedad. Estudios derivados del SARS concluyen que el tratamiento inicial con HBPM reduce la mortalidad un 48% a los 7 días y un 37% a los 28 días y logra una mejoría significativa del cociente presión arterial de oxígeno/fracción inspirada de O2 (PaO2/FiO2) al mitigar la formación de microtrombos y la coagulopatía pulmonar asociada 21 .…”

Section: Tratamiento Anticoagulante Para Pacientes Ingresados Con Covunclassified

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Recomendaciones sobre el tratamiento antitrombótico durante la pandemia COVID-19. Posicionamiento del Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología

Vivas

Roldán

Esteve‐Pastor

et al. 2020

Revista Española de Cardiología

120

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Please cite this article as: Vivas D, Roldán V, Esteve-Pastor MA, Roldán I, Tello-Montoliu A, Ruiz-Nodar JM, Cosín-Sales J, María Gámez J, Consuegra L, Luis Ferreiro J, Marín F, Arrarte V, Anguita M, CequierÁ, Pérez-Villacastín J, Recomendaciones sobre el tratamiento antitrombótico durante la pandemia COVID-19. ABSTRACTThe new coronavirus SARS-CoV-2, which gives rise to the highly contagious COVID-19 disease, has caused a pandemic that is overwhelming health care systems worldwide. Affected patients have been reported to have a heightened inflammatory state that increases their thrombotic risk. However, there is very scarce information on the management of thrombotic risk, coagulation disorders, and anticoagulant therapy. In addition, the situation has also greatly influenced usual care in patients not infected with COVID-19.

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“…But it was the first reports from Italy and other European countries, which emphasized the remarkably high incidence of pulmonary embolism and thrombosis in the most severe and fatal cases [59,60,63]. At present, there is an awareness of a few clinical and laboratory features of patients with COVID-19, which is thrombocytopenia, elevated d-dimer level, prothrombin time prolongation and disseminated intravascular coagulation [64,65]. The International Society of Thrombosis and Hemostasis (ISTH) recommends prothrombin time, platelet, fibrinogen and d-dimer to determine prognosis and identify patients requiring admission to hospital [65].…”

Section: Coagulation and Thrombosis In Covid-19mentioning

confidence: 99%

COVID-19 — Toward a comprehensive understanding of the disease

et al. 2020

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The evidence on the pathophysiology of the novel coronavirus SARS-CoV-2 infection is rapidly growing. Elucidating why some patients suffering from COVID-19 are getting so sick, while others are not, has become an informal imperative for researchers and clinicians around the globe. The answer to this question would allow rationalizing the fear surrounding this pandemic. Understanding of the pathophysiology of COVID-19 relies on unraveling of interplaying mechanisms, including SARS-CoV-2 virulence, human immune response, and complex inflammatory reactions with coagulation playing a major role. An interplay with bacterial co-infections, as well as the vascular system and microcirculation affected throughout the body should also be examined. More importantly, a comprehensive understanding of pathological mechanisms of COVID-19 will increase the efficacy of therapy and decrease mortality. Herewith, the authors present a combined viewpoint based on the current state of knowledge on COVID-19: beginning from the virus, its transmission, and mechanisms of entry into the human body, through the pathological effects on the cellular level, up to immunological reaction, systemic and organ presentation. Last but not least, currently available and possible future therapeutic and diagnostic options are briefly commented on. (Cardiol J 2020; 27, 2: 99-114)

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ISTH interim guidance on recognition and management of coagulopathy in COVID‐19

Cited by 1,750 publications

References 16 publications

Temporal detection and phylogenetic assessment of SARS-CoV-2 in municipal wastewater

Temporal detection and phylogenetic assessment of SARS-CoV-2 in municipal wastewater

Recomendaciones sobre el tratamiento antitrombótico durante la pandemia COVID-19. Posicionamiento del Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología

COVID-19 — Toward a comprehensive understanding of the disease

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